系统免疫炎症指数与营养控制状态评分对老年早期远端胃癌全腔镜手术病人预后的评估价值

doi:10.3969/j.issn.1003-9198.2023.07.015

摘要/Abstract

摘要： 目的探究系统免疫炎症指数(SII)与营养控制状态(CONUT)评分对老年早期远端胃癌全腔镜手术病人预后的预测效能。方法选择2019年1月至2022年1月我院收治的行全腔镜胃癌切除术的老年早期远端胃癌病人126例,术前3 d检测外周血血小板、淋巴细胞计数、中性粒细胞、血清白蛋白及总胆固醇水平,计算SII及CONUT评分。根据术后6个月随访结果将病人分为预后良好组和预后不佳组,采用多因素Logistic回归分析影响老年早期远端胃癌病人预后的相关因素。以ROC曲线下面积(AUC)评估SII及CONUT评分对老年早期远端胃癌病人预后的预测价值。结果 126例老年早期远端胃癌病人中预后不佳24例。单因素及多因素Logistic回归分析结果均显示,年龄大、SII升高、CONUT评分较高及浸润黏膜肌层M3为老年早期远端胃癌病人不良预后的危险因素(P＜0.05)。ROC曲线分析结果显示,SII及CONUT评分单一及联合预测老年早期远端胃癌病人不良预后的AUC分别为0.706(95%CI:0.610～0.852)、0.701(95%CI:0.594～0.826)、0.809(95%CI:0.759～0.941),两者单一预测效能低于联合预测(P＜0.05)。结论 SII及CONUT评分可用于辅助评估老年早期远端胃癌病人的预后,且预测效能良好。

关键词: 早期远端胃癌, 老年人, 系统免疫炎症指数, 营养控制状态评分

Abstract: Objective To explore the predictive efficacy of systemic immune-inflammation index(SII) and controlling nutritional status(CONUT) scores for the prognosis in the elderly patients with early distal gastric cancer undergoing total laparoscopic surgery. Methods From January 2019 to January 2022, a total of 126 elderly patients with early distal gastric cancer who underwent total laparoscopic gastrectomy in our hospital were enrolled. The peripheral blood platelet, lymphocyte count, neutrophil, serum albumin and total cholesterol levels were measured 3 days before the operation, and SII and CONUT score were calculated. According to the 6-month follow-up results, the subjects were divided into the good prognosis group and the poor prognosis group. Multivariate Logistic regression was used to analyze the relevant factors affecting the prognosis. The area under the receiver operating characteristic(ROC) curve(AUC) was used to evaluate the predictive value of SII and CONUT score for prognosis. Results Among 126 elderly patients with early distal gastric cancer, 24 presented with poor prognosis(18.75%). Multivariate Logistic regression analysis showed that older age, higher SII, higher CONUT score and M3 infiltrating muscularis mucosa were the risk factors for poor prognosis in the elderly patients with early distal gastric cancer. The results of ROC curve analysis showed that the AUC of SII and CONUT score alone and combination in predicting the prognosis was 0.706(95%CI: 0.610-0.852), 0.701(95%CI: 0.594-0.826) and 0.809(95%CI: 0.759-0.941) respectively, and the predicting efficiency of the two indexes was lower than that of the combination(P<0.05). Conclusions SII and CONUT score can be used to evaluate the prognosis of elderly patients with early distal gastric cancer.

Key words: early distal gastric cancer, aged, systemic immune-inflammation index, controlling nutritional status score

中图分类号:

R 735.2

朱斌, 谢海伟, 董建宁. 系统免疫炎症指数与营养控制状态评分对老年早期远端胃癌全腔镜手术病人预后的评估价值[J]. 实用老年医学, 2023, 37(7): 709-713.

ZHU Bin, XIE Hai-wei, DONG Jian-ning. Predictive value of systemic immune-inflammation index and controlled nutritional status score in elderly patients with early distal gastric cancer undergoing total laparoscopic surgery[J]. Practical Geriatrics, 2023, 37(7): 709-713.

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